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CDC Recommends Bivalent COVID-19 Vaccine Booster

On September 1, 2022, the Centers for Disease Control and Prevention (CDC) announced recommendations for a booster dose of updated COVID-19 vaccines: Moderna COVID-19 vaccine, bivalent for individuals 18 years of age and older and Pfizer/BioNTec COVID-19 vaccine, bivalent for individuals 12 years of age and older.

The updated vaccines protect against both the original SARS-CoV-2 strain and the most recent Omicron subvariants. People are eligible to receive an updated booster two months after their last vaccination, whether it was a primary or booster dose.

The U.S. Department of Health and Human Services has purchased 175 million doses of the updated vaccines and is distributing these at no charge to providers for immediate vaccination to your eligible members. The standard administration fee of $40 per vaccination will be submitted by providers under your health plan’s pharmacy benefit. Your members will have a $0 cost share.

Newly Approved Vaccine Products as of 09/02/2022

Vaccine

NDC

Product Name

Manufacturer's (Labeler) Name

Generic Name

Utilization Management Criteria 

PFIZER BIVAL INJ BA4/BA5

59267030401

59267030402

59267140401

59267140402

PFIZER-BIONTECH COVID-19 VACCINE/BIVALENT/BA.4/BA.5

PFIZER-BIONTECH

COVID-19 MRNA BIVALENT VACCINE-PFIZER IM SUSP 30 MCG/0.3ML

Min Age = 12 Years
Age edits may be overridden if DOB is incorrect

Max 1 dose/365 days

MODERNA BIVA INJ BA4/BA5

80777028205

80777028299

MODERNA COVID-19 VACCINE/BIVALENT/BA.4/BA.5

MODERNA US INC

COVID-19 MRNA BIVALENT VACCINE-MODERNA IM SUSP 50 MCG/0.5ML

Min Age = 18 Years

Age edits may be overridden if DOB is incorrect

Max 1 dose/365 days

 

Please contact your pharmacy benefit manager (PBM) or your MedCost Account Manager if you have any questions.